459 - Prognostic Value of HMGB1 Levels for Mortality in Neonates with Suspected Sepsis

Publication Number: 2447.459

PUSTA Orujova, Azerbaijan Medical University, Baku, Baki, Azerbaijan; Naila Sultanova, Azerbaijan Medical University, Baku, Baki, Azerbaijan

Background: Early identification of neonates at risk of death from sepsis remains a major challenge. High-mobility group box-1 protein (HMGB1) is a late pro-inflammatory mediator that may reflect disease severity and outcome.

Objective: To evaluate the relationship between serum HMGB1 levels and mortality in neonates with suspected sepsis and to assess its discriminative accuracy.

Design/Methods: A prospective cohort of 66 neonates (5 deaths, 61 survivors) was studied at Azerbaijan Medical University NICU. Serum HMGB1 concentrations were measured by ELISA on day 1–3 of life. Mortality was the primary outcome. Group differences were analyzed using the Mann–Whitney U test, and receiver operating characteristic (ROC) analysis was performed to determine predictive performance and optimal cutoff values.

Results: Median HMGB1 levels did not differ significantly between survivors and non-survivors (p = 0.215). However, ROC analysis showed a significant discriminative ability (AUC = 0.672, 95 % CI 0.509–0.835, p = 0.039). The best cutoff was 1,417 pg/mL, yielding 100 % sensitivity and 54 % specificity for mortality prediction. Although HMGB1 was not an independent risk factor for death, its elevated levels were associated with higher fatal outcomes.

Conclusion(s): HMGB1 demonstrates moderate but statistically significant accuracy for mortality prediction in neonates with suspected sepsis. ROC analysis supports its utility as a complementary biomarker for early risk stratification and clinical monitoring.

Comparisonal analysis of HMGB1 level related to mortality status
Comparisonal analysis of HMGB1 level related to mortality status.jpeg

Roc analysis of HMGB1 level for the mortality for suspected sepsis in neonates
Roc analysis of HMGB1 level for the mortality for suspected sepsis in neonates.jpeg

Overall model Quality of ROC analysis of HMGB1 in mortality
Overall model Quality.jpeg